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Irritable Bowel Syndrome

From Mediwikis

Chronic, relapsing and often life-long disorder. The pathophysiology is not known. Characterised by distinct symptoms but presentation to primary care can vary, most commonly 'diarrhoea predominant' or 'constipation predominant'. Symptoms sometimes overlap with other gastrointestinal disorders such as non-ulcer dyspepsia or coeliac disease. IBS most often affects people between the ages of 20 and 30 years and is twice as common in women as in men. Prevalence in the general population is estimated to be between 10% and 20%.

Symptoms

  • Abdominal pain or discomfort
    • Relieved by defecating, made worse by eating
  • Bloating
  • Change in bowel habit

Red Flags (Exclude)

History

  • Weight loss
  • Rectal bleeding
  • Family history bowel/ovarian cancer
  • Looser/more frequent stools for >6 weeks in patient >60

Examination/Investigation

  • Anaemia
  • Rectal masses
  • Abdominal masses
  • Inflammatory markers for IBD

Management

  • Reassurance and education
  • Diet change
  • Antispasmodic agents
  • Laxatives - for constipation
  • Antimotility agent (e.g. - loperamide) - for diarrhoea
  • Secondary treatment
    • TCAs
    • SSRIs